Download Equipment Loan Agreement - Rogers State University

Equipment Request/Loan Agreement
This is an Equipment Loan Agreement whereby equipment/materials are lent to individuals by Rogers State
University in furtherance of the mission of the University. By signing this Equipment Loan Agreement
Form, borrower has read and agrees to all of the following requirements summarized below:




Borrower must complete the equipment loan agreement.
Equipment will be loaned no more than 3 days unless given consent for a longer period.
In the event of loss or failure to return borrowed equipment/materials, borrower agrees to reimburse
Rogers State University the cost of purchase of new equipment of the same type.
In the event of damage to said equipment/materials, borrower agrees to pay for the cost of repair.
Date: ____________________ Requesting Persons Name: _______________________________________
Address: _______________________ City: _______________ State: _______ Postal Code: ____________
Phone Number: _______________ Request Date (s): ___________ Return Date: _________ Time: _______
Purpose for Loaned Equipment/Materials: _____________________________________________________
The period of loan is from approved request date until approved return date. Borrower understands that any
extensions over the approved loan period without prior consent may result in borrower’s privilege to borrow
equipment to be suspended.
I, the undersigned, agree to assume all responsibility for loss or damage to the equipment/materials listed on
the following page from Rogers State University.
Borrower’s Signature: ______________________________________________ Date: ______________
Rented Equipment Return
Received By: ________________________ Date: _______________ Time: _________________
Equipment was returned in same condition that it was loaned out: Yes or No
Comments______________________________________________________________________________
_______________________________________________________________________________________
_________________________________________________________________________________
Equipment was returned by appointed date and time? Yes or No
Comments______________________________________________________________________________
_______________________________________________________________________________________
_________________________________________________________________________________
Acknowledged By: ____________________________________________________ Date: ___________
Notice of Availability of Equipment and/or Instructional Materials
Equipment Request/Loan Agreement



Equipment availability may vary depending on the amount of advance notice given by the requestor.
Equipment reservation is based upon availability, first-come-first-serve basis and may not always be available for date
and/or time requested.
If you are approved for an equipment loan and find you do not need the equipment, notify us as soon as possible.
Equipment/Item
RSU Inventory ID
Qty
Total